A 41-year-old member asked:
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what distinguishes nmol/l in salivary from that in free plasma cortisol?

2 doctor answers
Dr. David Sneid
40 years experience Endocrinology
There is: No way to compare since they measure different things. The salivary tests measures total cortisol, which is different from the free cortisol faction in the blood. Check w/your doctor. Either test can be effective when utilized properly.
Answered on Jul 18, 2013
Dr. Ward Dean
Dr. Ward Dean answered
42 years experience Anti-Aging Medicine
Can't compare #s: The numbers can't be compared--only their relationship to "normal" for each type of test (i.e., compare saliva with saliva normals, and serum with serum normals). In blood, there are "free" and "bound" levels of hormones, showing free (active) hormone, and hormone "bound" (inactivated) to serum proteins. In saliva, the amount of hormone is all free--there are no serum proteins to bind with.
Answered on Mar 8, 2015
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1 comment
Dr. Ward Dean
Dr. Ward Dean commented
42 years experience Anti-Aging Medicine
Provided original answer
About 70% of circulating serum cortisol is tightly bound to cortisol-binding globulin (CBG), and about 10% is loosely bound to albumin. Only free cortisol is biologically active. That's one good thing about salivary levels--they only measure the free cortisol (and free forms of other hormones).
Mar 8, 2015

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A 40-year-old female asked:
Dr. David Sneid
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Generally not: Necessary, but check w/your specific lab to make sure of their requirements.

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